小儿推拿联合中药敷脐治疗小儿腹泻疗效及对肠道菌群影响

Effect of pediatric massage combined with application of traditional Chinese medicine on navel in treating children with diarrhea and its influence on intestinal flora

目的小儿腹泻严重损害患儿消化系统,严重时甚至引起脱水、酸碱平衡失调和水电解质紊乱等并发症,不利于患儿正常发育,本研究分析推拿联合中药敷脐治疗腹泻患儿效果及对肠道菌群影响,为临床诊治小儿腹泻提供参考依据。方法选择2017-01-01-2018-06-01安阳市中医院91例腹泻患儿为研究对象,按照年龄、性别和病程均衡可比的原则分组,对照组45例给予抗病毒、补液、助消化和纠正水电解质紊乱等常规治疗,观察组46例在对照组基础上联合小儿推拿和中药敷脐治疗,对比两组患儿治疗后症状体征改善时间、肠道菌群水平变化和临床疗效。结果观察组治疗后大便性状好转时间为(1.51±0.60)d,低于对照组的(2.99±1.31)d,t=6.903,P<0.001;脱水改善时间为(0.81±0.26)d,低于对照组的(1.51±0.77)d,t=5.784,P<0.001;全身症状改善时间为(1.90±0.59)d,低于对照组的(2.89±0.88)d,t=6.289,P<0.001;止泻时间为(2.39±1.01)d,低于对照组的(3.61±1.19)d,t=5.276,P<0.001;酵母样真菌水平为(3.01±0.11)CFU/g,低于对照组的(3.36±0.49)CFU/g,t=4.725,P<0.001;乳杆菌水平为(9.96±0.61)CFU/g,高于对照组的(9.38±0.68)CFU/g,t=4.285,P<0.001;肠球菌水平为(11.58±0.91)CFU/g,高于对照组的(10.91±1.11)CFU/g,t=3.152,P=0.001;总有效率为95.65%,高于对照组的80.00%,χ~2=5.244,P=0.022。结论小儿推拿联合中药敷脐能够有效恢复腹泻患儿肠道菌群平衡,消除患儿症状体征。

OBJECTIVE Children with diarrhea seriously damage the digestive system of patients,and even cause serious complications such as dehydration,acid-base balance disorder,water and electrolyte imbalance,which is not conducive to the normal development of children.This study analyzes the effect of pediatric massage combined with application of traditional Chinese medicine on navel to provide a reliable reference for clinical diagnosis and treatment.METHODS A total of 91 children with diarrhea in Anyang Traditional Chinese Medicine Hospital from January 1,2017 to June 1,2018 were divided into two groups according to the age,sex and disease course.The control group of 45 cases received antiviral,fluid replacement,digestion and correction of water and electrolyte disorders.Another 46 patients in the observation group were treated with pediatric massage and navel application of traditional Chinese medicine.The improvement of symptoms and signs,intestinal flora changes and clinical efficacy were compared between the two groups.RESULTS After treatment,the improvement time of stool traits in the observation group was(1.51±0.60)d,which was lower than that in the control group(2.99±1.31)d,t=6.903,P<0.001.The improvement time of dehydration in the observation group was(0.81±0.26)d,which was lower than that in the control group(1.51±0.77)d,t=5.784,P<0.001.The improvement time of systemic symptoms in the observation group was(1.90±0.59)d,which was lower than that in the control group(2.89±0.88)d,t=6.289,P<0.001.The anti-diarrhea time in the observation group was(2.39±1.01)d,lower than that in the control group(3.61±1.19)d,t=5.276,P<0.001.The level of yeast-like fungi in the observation group was(3.01±0.11)CFU/g,lower than that in the control group(3.36±0.49)CFU/g,t=4.725,P<0.001.The level of lactobacillus in the observation group was(9.96±0.61)CFU/g,higher than that in the control group(9.38±0.68)CFU/g,t=4.285,P<0.001.The level of enterococcus in the observation group was(11.58±0.91)CFU/g,higher than that in the control group(10.91±1.11)CFU/g,t=3.152,P=0.001.The total effective rate of observation group was 95.65%,higher than that of control group(80.00%),2χ=5.244,P=0.022.CONCLUSIONS Pediatric massage combined with navel application of traditional Chinese medicine can effectively restore the balance of intestinal flora in children with diarrhea and eliminate the symptoms and signs of children.